Dataset Information

Older adults using a patient portal: registration and experiences, one year after implementation.

ABSTRACT:

Background and objectives

The interest of older adults in using patient portals is rising, yet subject to functional and usability barriers. This study aims to gain insight into registration rates and experiences of older adult patients using a patient portal, one year after implementation in an academic hospital.

Methods

Registration rates for one year were collected via automated data extraction. Older adult patients' experiences were collected through a survey, available via the portal in the last three months of the year.

Results

Older adults were a large user group of the patient portal and appreciated its functionalities. In one year, 10,679 older adult patients (aged 56+) registered, which constituted 47% of total portal registrations. The 131 older adult survey respondents had a mean age of 64.5 years and 40% indicated that they liked to review their medical information and appointments via the portal. Yet, older adults experienced user interaction issues and had higher expectations of content within the portal and patient/provider communication through the portal. Of the survey respondents, 22% experienced usability issues at login and in viewing test results, 15% commented on late or no responses by providers on patients' sent messages and 24% expected the portal to provide medical history information.Implications: Patient portal designs should be optimized to usability needs of older adults. Portals preferably include medical history information, physicians' notes and require prompt responses of providers.

SUBMITTER: Wildenbos GA

PROVIDER: S-EPMC6120166 | biostudies-literature | 2018 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Older adults using a patient portal: registration and experiences, one year after implementation.

Wildenbos Gaby Anne GA Maasri Karim K Jaspers Monique M Peute Linda L

Digital health 20180101

<h4>Background and objectives</h4>The interest of older adults in using patient portals is rising, yet subject to functional and usability barriers. This study aims to gain insight into registration rates and experiences of older adult patients using a patient portal, one year after implementation in an academic hospital.<h4>Methods</h4>Registration rates for one year were collected via automated data extraction. Older adult patients' experiences were collected through a survey, available via th ...[more]

PMID: 30186619

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Project description:BACKGROUND:The older adult population (65 years or older) in the United States is growing, and it is important for communities to consider ways to support the aging population. Patient portals and electronic personal health records (ePHRs) are technologies that could better serve populations with the highest health care needs, such as older adults. OBJECTIVE:The aim of this study was to assess the existing research landscape related to patient portal and ePHR use and experience among older adults and to understand the benefits and barriers to older adults' use and adoption of patient portals and ePHRs. METHODS:We searched six pertinent bibliographic databases for papers, published from 2006 to 2016 and written in English, that focused on adults 60 years or older and their use of or experience with patient portals or ePHRs. We adapted preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to review papers based on exclusion and inclusion criteria. We then applied thematic analysis to identify key themes around use, experience, and adoption. RESULTS:We retrieved 199 papers after an initial screening and removal of duplicate papers. Then we applied an inclusion and exclusion criteria, resulting in a final set of 17 papers that focused on 15 separate projects. The majority of papers described studies involving qualitative research, including interviews and focus groups. They looked at the experience and use of ePHRs and patient portals. Overall, we found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet. We found 2 facilitators: (1) technical assistance and (2) family and provider advice. We also reported on older adults' experience, including satisfaction with the system and improvement of the quality of their health care. Several studies captured features that older adults wanted from these systems such as further assistance managing health-related tasks and contextual health advice and tips. CONCLUSIONS:More research is needed to better understand the patient portal experience among older adults from initial use to adoption. There are also opportunities to explore the role of design in addressing barriers and supporting facilitators to patient portal and ePHR use. Finally, the future use of these systems by older adults should be anticipated and considered in the design process.

Project description:BackgroundGiving patients access to their health information is a provincial and national goal, and it is critical to the delivery of patient-centered care. With this shift, patient portals have become more prevalent. In Alberta, the Alberta Health Services piloted a portal (MyChart). There was a need to identify factors that promoted the use of this portal. Furthermore, it was imperative to understand why there was variability in uptake within the various clinics that participated in the pilot.ObjectiveThis study aims to identify potential factors that could improve the uptake of MyChart from the perspectives of both users and nonusers at pilot sites. We focused on factors that promoted the use of MyChart along with related benefits and barriers to its use, with the intention that this information could be incorporated into the plan for its province-wide implementation.MethodsA qualitative comparative case study was conducted to determine the feasibility, acceptability, and initial perceptions of users and to identify ways to increase uptake. Semistructured interviews were conducted with 56 participants (27 patients, 21 providers, 4 nonmedical staff, and 4 clinic managers) from 5 clinics. Patients were asked about the impact of MyChart on their health and health care. Providers were asked about the impact on the patient-provider relationship and workflow. Managers were asked about barriers to implementation. The interviews were recorded, transcribed verbatim, and entered into NVivo. A thematic analysis was used to analyze the data.ResultsResults from a comparison of factors related to uptake of MyChart in 5 clinics (2 clinics with high uptake, 1 with moderate uptake, 1 with low uptake, and 1 with no uptake) are reported. Some theoretical constructs in our study, such as intention to use, perceived value, similarity (novelty) of the technology, and patient health needs, were similar to findings published by other research teams. We also identified some new factors associated with uptake, including satisfaction or dissatisfaction with the current status quo, performance expectancy, facilitating conditions, behavioral intentions, and use behavior. All these factors had an impact on the level of uptake in each setting and created different opportunities for end users.ConclusionsThere is limited research on factors that influence the uptake of patient portals. We identified some factors that were consistent with those reported by others but also several new factors that were associated with the update of MyChart, a new patient portal, in the clinics we studied. On the basis of our results, we posit that a shared understanding of the technology among patients, clinicians, and managers, along with dissatisfaction with nonportal-based communications, is foundational and must be addressed for patient portals to support improvements in care.

Dataset Information

Older adults using a patient portal: registration and experiences, one year after implementation.

Background and objectives

Methods

Results

Publications

Older adults using a patient portal: registration and experiences, one year after implementation.

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